A 22-year-old primigravida gives birth to a boy at 38 weeks’ gestation. On physical examination, the infant appears normal except for an abnormal right hip click with the Ortolani maneuver. Ligamentous laxity of the hip is noted. The mother asks if there is any risk that future children will be born with a similar malformation. What is the most likely recurrence risk for future pregnancies?
A 22-year-old primigravida gives birth to a boy at 38 weeks’ gestation. On physical examination, the infant appears normal except for an abnormal right hip click with the Ortolani maneuver. Ligamentous laxity of the hip is noted. The mother asks if there is any risk that future children will be born with a similar malformation. What is the most likely recurrence risk for future pregnancies?
💡 Explanation
**Core Concept**
The Ortolani maneuver is a clinical test used to assess for developmental dysplasia of the hip (DDH), a condition where the hip joint doesn't form properly. DDH can be caused by various factors, including ligamentous laxity, family history, and female sex.
**Why the Correct Answer is Right**
The most common type of DDH is congenital dislocation of the hip, also known as idiopathic developmental dysplasia of the hip. This condition has a strong familial component, with a higher recurrence risk in families with a history of DDH. The risk is higher if there is a first-degree relative (parent or sibling) with a history of DDH. In this case, the risk of recurrence in future pregnancies is higher due to the genetic component.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not take into account the genetic component of DDH. While environmental factors may contribute to the development of DDH, the risk is higher in families with a history of the condition.
**Option B:** This option is incorrect because the risk of recurrence is higher than 1 in 10. Studies have shown that the risk of recurrence in families with a history of DDH is significantly higher than this.
**Option C:** This option is incorrect because it does not accurately reflect the risk of recurrence in future pregnancies. While the risk is higher in families with a history of DDH, it is not as low as 1 in 100.
**Clinical Pearl / High-Yield Fact**
It's essential to remember that DDH has a strong familial component, and a history of the condition in a first-degree relative increases the risk of recurrence in future pregnancies. This is an important consideration for families with a history of DDH, and they should be counseled accordingly.
**Correct Answer:** D. 5%
✓ Correct Answer: B. 5%
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